Lithograph of Ellen Hazard

The first ever cholera epidemic in the British Isles started in Sunderland in the autumn of 1831. The disease had spread from India to Baltic ports like Danzig, Hamburg and Riga. There was lively trade between these ports and Sunderland, so it was no surprise to the newly created Board of Health when the first suspected cases were found in Sunderland, even though they did not know how the disease was spread. The first victim was Ellen Hazard, a 12 year old girl from Low Street, Sunderland who was buried on 19 October 1831.

The epidemic spread through Tyneside and then on to the rest of Britain. 32,000 people died in Britain, the result of a global pandemic that killed millions. Further outbreaks occurred in 1848, 1853 and 1866, each time causing thousands of people to suffer a painful and unpleasant death. At first, doctors had little idea about what caused cholera. It was thought that the disease was carried in the air, but all kinds of precautions were urged. The link between cholera and contaminated water was not proved until 1854 when Dr John Snow (who had first experienced the disease whilst working in the North East) discovered cholera in a well that had been contaminated by a cess pit.

(  Report from the General Board of Health. October 31st 1853 ).
Soham

Ten deaths from cholera and two from diarrhoea are reported as having occurred in Soham since the 21st October, six from cholera and one from diarrhoea happened within the last 30 hours prior to the despatch of the latest accounts. Upwards of 40 cases ( some very severe in their character ) occurred on the 30th alone. From 120 to 130 cases of choleraic diarrhoea are stated to have taken place in various parts of the district. Dr. Lewis has been directed by the General Board of Health to visit the locality immediately, to advice with Local authorities as to the adoption of precautionary measures.

( Report from the General Board of Health November 7th 1853 )
Ely

Oct. 29th to Nov. 4th- Cholera deaths 2.

The officer of health of Ely reports that five cases of cholera have occurred in that city, two of which have proved fatal. Neither of these appears to have had communication with Soham, nor with each other, and they occurred in different parts of Ely. As usual, both the deceased lived in most unhealthy localities. The inquest furnishes an account of the locality in which the first victim resided, and of the second it is only necessary to add the name, Little London. In Mr. Lees report, in 1849, on the sanitary condition of Ely, it is stated that the mortality in this particular locality was then 45 in the 1000.
Previously to the occurrence of these fatal cases the officer of health had made a report to the local board of health on the wretched condition of this locality, and the local board of health had formed themselves into a committee and made a house-to-house visitation of the usual seats of epidemic disease. The result of their inquiries has been the discovery of nuisances as plentiful as in 1848-49. No unusual amount of diarrhoea appears to be prevailing at present. Board meetings have been held daily during the last week. Dr. Waller Lewis, being at Soham, was requested to visit Ely to assist in carrying into effect forthwith such precautionary measures as were practicable.

Soham

The condition of this town is an example of that of many others, and of the difficulty, when an extraordinary epidemic occurs, of carrying into effect any effectual preventive measures.  It also illustrates the destruction of life and the loss in money occasioned by the almost constant presence of typhus and other forms of zymotic disease.  Up to the 6th November, 29 fatal cases of cholera had occurred.
A partial and deceptive lull in the progress of the epidemic appears to have taken place in the middle of last week, but the disease began to re-assume its virulent form during the night of the 4th.  An old man who at 4o'clock p.m. held the horse of one of the medical officers while he entered the house to visit a patient, and who then said that he was perfectly well, although it afterwards appeared that at that very time he was labouring under premonitory symptoms, was taken ill in the night, and, notwithstanding all medical aid died in the morning. " When shortly afterwards I inspected the house," says Dr. Waller Lewis, " I found his three grandchildren all dangerously ill, two of them with only slight chances of recovery.  The house was one of those which I had previously described as wretched and dirty in the extreme, with large ditches of filthy water strongly impregnated with night soil in front and behind it, and a privy in an indescribable condition in the back yard.
This is in Bull Lane, where, and in the  immediate neighbourhood, are numerous other houses in a similar condition.  Many of these houses have lost one or more of their late inhabitants, and still contain from one to three or four cases of the disease in one or other of its stages.  I am quite at a loss to know what can be done for these unfortunates.  From the reports of the medical attendants, medicine seems to exert little controlling influence over the disease.  Nothing short of a wholesale removal of the people from their present infected abodes can prevent many more falling victims to the pestilence.  Unluckily, from the nature of this place, this step is impracticable to any extent.  Soham is a town, or rather a long, straggling village, with but few houses untenanted.  The few that are to be had are mostly situated on the Commons, which are intersected everywhere with full ditches, and dotted frequently with pools of stagnant water.  In the winter and wet weather these Commons are for weeks and months together ankle-deep in water, and in many places quite impassable.  In fact, they labour under the same disadvantages and defects of non-drainage and saturated soils as the most infected localities themselves.
" Some conception may be formed of the unhealthy condition and consequent cost to the union of some of these Commons, from the fact that I visited a row of four or five cottages on Ina-fen-common, where there were then some cases of diarrhoea.  I was informed by one of the magistrates, and the statement was confirmed by one of the inhabitants, that in the Autumn there had been 18 or 19 cases of fever in those few houses.  The Soham guardian assured me that they had cost the union between 50 shillings and 60 shillings a week, for many weeks together, in wine alone.  Can the do-nothing system be allowed to continue much longer ?.  In one house in Bull Lane, the mother lay dying with cholera in one room, and five children vomiting and purged in one bed in an adjoining room, which is so constructed that it is only by bending the body to nearly a right angle that I could approach the bed to examine the sufferers.  The mother, I regret to say, has died this morning. A local sanitary committee, established here at my suggestion, and with plenary powers and authority from the Newmarket Board of Guardians, are now most energetically and praiseworthily exerting themselves to remove the diseased to another set of cottages.  But it is doubtful whether much benefit will be derived from this from the circumstances previously stated.
More good will certainly accrue from another step also in process of execution-namely, removing those that are still unaffected to a house in a dry and healthy locality.  Unluckily this will accommodate but three families, a mere fraction of those that ought to be removed.  From local circumstances, the town of Soham is in a state of most deplorable helplessness. It is six miles from the nearest town, Ely, and seven from Newmarket, where the guardians sit.  There is no communication with either of those towns but by private conveyance.  No coach, omnibus, or fly is kept in the place.  If such conveyance is required a messenger must be despatched to one of these towns to request one to be sent.  It is with the greatest difficulty the sanitary committee have borrowed a horse and cart to convey the invalids and some necessary articles of furniture to the hired cottages.  The town will owe an eternal debt of gratitude to those gentlemen who have combined to form a Local Board of Health.  The vicar, the Rev. Henry Tasker, who had quitted the place to go to Brighton for his health, returned immediately he received intelligence of the virulent nature of the outbreak.  His two curates, who have both suffered from slight attacks of the epidemic, are, together with the magistrates and the Local authorities and some other gentlemen, indefatigable in their exertions.
" One of the medical men is unfortunately an invalid and unable to leave his house; and this throws additional labour on the other two, whose exertions are beyond praise.  I feel convinced that they would soon have been obliged to give in, but the two house-to-house visitors from London have just arrived, and are now in full work.  I hope, therefore, to be able shortly, under Divine favour, to report a more favourable state of things.
"In the meantime I have to report that four deaths have taken place here today, and several children are in a state that affords but little room for hope.
" To show the virulent nature of the poison, and how thoroughly impregnated therewith an infected house becomes, I adduce the following cases of several members of the same family suffering at the present time:-
In the family of H. 3 members are labouring under the disease, the family of T. 3 members, the family of H. 2 members, the family of P. 7 members, the family of A. 5 members, the family of H. 5 members, the family of B. 4 members, the family of G. 3 members, the family of L. 3 members, and the family of H. 6 members ( NOTE. No surnames are given just the initials ),.
There are at present under treatment: Diarrhoea, 82; approaching Cholera, 2; Cholera, 4.
In Waterside alone there are 24. In Bull Lane, 20.

Report from the General Board of Health November 8th 1853
Soham

The foggy, damp atmosphere and cloudy weather which have prevailed in this district during the last two days appear to have favoured  the spread of the epidemic.
At a meeting of the sanitary committee, held yesterday, a resolution was unanimously passed to erect two or three large booths or other buildings of wood, to receive the sick and their families from the infected localities,  as no measure short of this appeared likely to prevent many of the poorer classes who inhabit the damp and polluted districts from falling victims to the pestilence.  But it is stated that both workmen and materials are so difficult to procure in this place that much time must necessarily elapse before any place fit to receive cholera patients can be erected.  " In the meantime," says Dr. Walter Lewis, " there is a constant addition of fresh cases, among which children, the most delicate tests of impure air form a large proportion. All the children attacked suffer from incessant vomiting; this symptom being rarely absent.  No nurses having been procured, or being likely to be obtained from the town or from Newmarket, two have been sent from Addenbrokes Hospital, at Cambridge."
Thirty fresh cases of premonitory symptoms have been developed since last night, and another bad case of cholera.

Report from the General Board of Health November 9th 1853

Soham
( Deaths from the epidemic )
To November 7th, 32 deaths
November 8th, 3 deaths
----------------------

Isleham

There has been an outbreak of the epidemic in this large village,  Dr. Waller Lewis, who on hearing of the occurrence at once proceeded there, states that " it is in the most deplorable condition.  Great numbers of the people live in large hollows in the ground, from which many years ago building stone was extracted.  In one pit there are nearly 500 people in a state of great deprivation and dirty in the extreme.  In the first house I entered one corpse had just been placed in a coffin, another poor child was nearly ready for his last narrow resting place, and a third had a fair chance of recovery.  Six deaths had already occurred, and the medical officer had between 30 and 40 severe cases on his hands.  The number of inhabitants is between 2,000 and 3,000.  There is but little medicine and not one druggists shop in the village, which is 5 or 6 miles from the nearest town.
" Few private houses are provided with privies, and there are but four public necessaries, which have not been cleared out for nearly two years."

CHOLERA AT SOHAM
To the Editor of the Times
From Thomas Hustwick of Soham, 9th November 1853

Sir,- A sense of duty to my fellow townsmen imposes upon me the obligation of referring to certain reports emanating from the General Board of Health and published in The Times, and of correcting two or three statements therein, which are calculated to do considerable injury to the trade and interests of the town.  And first, I have to complain of the general sweeping statement which appeared in The Times of Friday, the 4th November, and furnished to the General Board of Health by Dr. Waller Lewis, viz.:
" That the crying evil - the prime cause of the virulent form of the epidemic now raging - is the quantity of stagnant water met with at every step.  The whole town is an assemblage of open ditches, the water in many of which is perfectly saturated at the present time with decomposing animal and vegetable matter."
It may be desirable I should state, for the information of those who are unacquainted with Soham, that it is an extensive parish, comprising between 14,000 and 15,000 acres of land, and that the principal street of the town is upwards of a mile in length - forming the high road from Ely to Newmarket.
However applicable Dr. Waller Lewis's statement may be to certain localities in the parish, the Main Street is not deserving any such condemnation; for I defy Dr. Waller Lewis to find one open ditch from the commencement of Hall Street to the end of Sand Street - the whole length of the thoroughfare abovementioned.
I took an opportunity of expressing my surprise at the statement, at a meeting of our sanitary committee on Saturday last, when Dr. Waller Lewis replied,  " If any gentlemen complained of his reports, he had better write to The Times to correct them,"  I regret to find additional misstatements,  from the same source, in your journal of Tuesday the 8th November, and, as they cast most undeserved reflection upon our town and its inhabitants, I feel it incumbent upon me, as a member of the sanitary committee, to notice them, otherwise I should have been content to pass over the first report, above alluded to, without further observation.
Dr. Waller Lewis reports, " The town of Soham is in a state of deplorable helplessness," and adduces, in support of such an uncalled-for and unjustifiable expression, that no coach, omnibus, or fly is kept in the place, forgetting that in a country town almost every person, whose business or engagements call him from home, keeps some conveyance of his own; and further, what, if un contradicted, would  reflect indelible disgrace, and cast a lasting stigma upon the better feelings of the inhabitants.  " that it was with the greatest difficulty the sanitary committee borrowed a horse and cart to carry the invalids and some necessary articles of furniture to the hired cottages."
Surely Dr. Waller Lewis's memory must be of the most treacherous kind, for it cannot be forgotten that, when the sanitary committee met on Sunday morning ( many of whom devoted the whole of that day to attend to the wants and necessities of the afflicted and destitute ). and the removal of some of the families from the infected districts was determined upon, one of the committee ( Mr. King ) at once placed at their disposal a covered cart: but, a more convenient one having been proposed, the officer of the committee was immediately despatched for it, and in the course of half an hour the cart was at the place appointed ; and several of the committee personally superintended the removal of the sick, whose lives, it was hoped, might thus be spared.  So much for the " greatest difficulty " in borrowing a horse and cart.
I regret Dr. Waller Lewis should consider it necessary to introduce topics of this nature into his reports, which tend very much to destroy the influence of his opinions, and are altogether beside the sphere of his official duties.  Much, very much, I know full well, requires to be done in certain localities, as to the removal of nuisances ( and to this object the sanitary committee, who sit twice every day, are directing their most patient and unwearied attention ); and much also as to a better system of drainage - to which those gentlemen are prepared to give their undivided attention, immediately the more weighty duties now devolving upon them will allow; but it is unfair and unjust to all that so little care and consideration is shown in preparing the reports alluded to, which are calculated to create unnecessary alarm and unfavourable impressions in the minds of friends and others at a distance.
I cannot conclude this letter without remarking that it is a matter of observation by all who have known Soham during a period of 10 or 15 years, that no other town, of its size and population, has improved to such an extent during a like period; and to its general healthiness the longevity of its inhabitants and the gravestones in our churchyard bear ample testimony.
I am, Sir, your obedient servant,
Soham, Nov. 9.         Thomas Hustwick.

Report from the General Board of Health November 14th 1853
Ely

The local board of health are stated to be at work most efficiently in clearing away all such nuisances as, in the present state of the drainage, can be removed.  From the low situation of parts of the town, many thing must remain in their present condition till the house sewerage is connected with the main drains.  These are now being proceeded with as rapidly as possible.  There have been several severe cases of cholera and diarrhoea in one district, whence a sub-committee are now at work removing the inhabitants to a more healthy situation.  No deaths have occurred for the last few days.

Soham
November 12th and 13th,  Cholera deaths 3.

The active exertions of the sanitary committee, together with the house-to-house visitation and the more favourable weather, appear to have entirely checked the spread of the disease, at any rate for the present.  There have been no deaths since the 9th.  " The committee." says Dr. Waller Lewis, " will now be able to consider carefully the important question of draining the Commons and low-lying districts. If this is scientifically done, there is no reason why Soham should not be as healthy a town as any that is to be found in any of the eastern counties.  I believe there will be then no repetition of the fact that the mortality during the present visitation  has been almost four times as great as it was during the previous one, there having been 10 deaths then and 38 now."  An error which found its way into one of the reports from this place should be corrected; it was stated, " the whole town is an assemblage of open ditches."  whereas it should have been, " the infected locality is a series of open ditches."

Report from the General Board of Health November 18th 1853
Soham

Mr. Lee states that, during his inspection of Soham, he found the course taken at Newcastle and other places in the North ( of covering up and burying with fresh earth nuisances which it would have been dangerous to remove during the pestilence ) had been almost universally adopted at Soham.  Mr. Willis, a surgeon in extensive practice, states the following as the result of the experience of this proceeding in Soham.
" There is no doubt here now that the use of earth to cover, bury, and soak up the foul nuisances is the best step that can be taken.  It takes up and fixes all the noxious gases immediately."

State of the Public Health report
3rd February 1854

In the sub-district of Soham, in Cambridgeshire, the deaths, which had been 50 in the corresponding quarter of 1852, rose to 112 last quarter, in consequence of cholera in October and November, which was fatal to 61 persons. In the district of Ely, in the same county, a great deal of fever prevailed at Stretham, and 2 cases of cholera occurred at Haddenham, while in the parish of Sutton diarrhoea attacked the inmates of almost every house.  The deaths were 61 in the sub-district of Ely, against 39 in the corresponding quarter of 1852, and 17 of those were caused by cholera.